§ 915.2. Principles governing data access.
(a) Confidentiality principle. The Council, under the mandates of and authority provided in the act will assure the confidentiality of information received as a result of the enactment and implementation of the act. This chapter establishes policies and procedures to protect and maintain the confidentiality of individual patient information which is submitted to the Council. These policies and procedures assure that information and data will not be released or be accessible if the release of the information or data could reasonably be expected to reveal the identity of an individual patient. If conflicts between patient confidentiality and release of data arise, patient confidentiality will take priority.
(b) Other principles.
(1) The Council will facilitate the continuing provision of quality, cost-effective health services throughout this Commonwealth by providing data and information to the purchasers and consumers of health care on the cost and quality of health care services.
(2) The Council will assure that information and data received by the Council will be utilized by the Council for the benefit of the public.
(3) The Council will assure that data will not be released or be accessible that does not simultaneously disclose charge or payment as well as provider quality and provider service effectiveness.
(4) The Council will assure that data will not be released or be accessible which could reasonably be expected to reveal the identity of a purchaser, other than a purchaser requesting data on its own group or an entity entitled to the purchaser’s data under the act.
(5) The Council will assure that data will not be released or be accessible which relates to actual payments to an identified provider made by a purchaser, except that this does not apply to a purchaser requesting data on the group for which it purchases or otherwise provides covered services or access to that same data by an entity entitled to the purchaser’s data under the act.
(6) The Council will assure that data which discloses discounts or differentials between payments accepted by providers for services and their billed charges obtained by identified payors from identified providers will not be released or accessible unless comparable data on other payors is also released and the Council determines that the release of the information is not prejudicial or inequitable to an individual payor or provider or group thereof.
(7) The Council will assure that access to data, as defined in this chapter, by a party, including, but not limited to, purchasers, collective bargaining representatives, general public and Council members, will be in accordance with the procedures contained in this chapter.
(8) The Council is required to uphold the act and to prohibit the unauthorized use of Council data as set forth in the act.
(9) The Council will be very restrictive with regard to the release of data. Requests for data will be reviewed in accordance with the confidentiality protections, as enumerated in § § 915.21—915.25 (relating to confidentiality protections). If the Council determines that the request violates the Council’s confidentiality protections, the Council may seek to amend cell sizes, propose alternative ways to examine data, propose alternative ways to look at specific issues and otherwise amend the scope of the report or deny the request.
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